Semin Plast Surg 2020; 34(04): 260-264
DOI: 10.1055/s-0040-1721762
Review Article

Avoiding Complications in Functional and Aesthetic Rhinoplasty

Marc H. Hohman
1   Department of Facial Plastic and Reconstructive Surgery, Madigan Army Medical Center, Tacoma, Washington
,
Aurora G. Vincent
2   Facial Plastic Surgery Associates, Fort Worth, Texas
,
Spencer R. Anderson
3   Department of Plastic and Reconstructive Surgery, Boonshoft School of Medicine, Wright State University, Dayton, Ohio
,
Yadranko Ducic
2   Facial Plastic Surgery Associates, Fort Worth, Texas
,
Spencer Cochran
4   Dallas Rhinoplasty, Dallas, Texas
› Author Affiliations

Abstract

Historically, nasoseptal surgery favoring functional considerations has compromised aesthetic ones, and vice versa, but modern techniques have evolved that allow symbiotic achievement of both goals. Nasoseptal surgery is among the most commonly performed plastic surgical procedures in the United States, and while it is generally well tolerated, there are a few surgical and aesthetic complications of which to be aware. Herein, we review surgical techniques that improve the nasal airway and nasal aesthetics in a top-down approach with a discussion of possible ensuing complications.

Disclosures

The authors have no financial disclosures. The work herein does not necessarily represent the views of the United States Army or Department of Defense.




Publication History

Article published online:
24 December 2020

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Cochran CS, Landecker A. Prevention and management of rhinoplasty complications. Plast Reconstr Surg 2008; 122 (02) 60e-67e
  • 2 Zhao K, Jiang J. What is normal nasal airflow? A computational study of 22 healthy adults. Int Forum Allergy Rhinol 2014; 4 (06) 435-446
  • 3 Sheen JH. Spreader graft: a method of reconstructing the roof of the middle nasal vault following rhinoplasty. Plast Reconstr Surg 1984; 73 (02) 230-239
  • 4 Mink PJ. Le nez comme voie respiratoire. Presse Otolaryngol Belg 1903; 21: 481-496
  • 5 Miman MC, Deliktaş H, Özturan O, Toplu Y, Akarçay M. Internal nasal valve: revisited with objective facts. Otolaryngol Head Neck Surg 2006; 134 (01) 41-47
  • 6 Wexler DB, Braverman I, Amar M. Histology of the nasal septal swell body (septal turbinate). Otolaryngol Head Neck Surg 2006; 134 (04) 596-600
  • 7 Catalano P, Ashmead MG, Carlson D. Radiofrequency ablation of septal swell body. Ann Otolaryngol Rhinol 2015; 2 (11) 1069
  • 8 Zald PB. Septal swell body treatment by transmucosal, incisionless radiofrequency ablation. Oper Tech Otolaryngol--Head Neck Surg 2019; (e-pub ahead of print) DOI: 10.1016/j.otot.2019.10.001.
  • 9 Kim SJ, Kim HT, Park YH, Kim JY, Bae JH. Coblation nasal septal swell body reduction for treatment of nasal obstruction: a preliminary report. Eur Arch Otorhinolaryngol 2016; 273 (09) 2575-2578
  • 10 Standlee AG, Hohman MH. Evaluating the effect of spreader grafting on nasal obstruction using the NOSE scale. Ann Otol Rhinol Laryngol 2017; 126 (03) 219-223
  • 11 Gassner HG. Structural grafts and suture techniques in functional and aesthetic rhinoplasty. GMS Curr Top Otorhinolaryngol Head Neck Surg 2010; 9: Doc01
  • 12 Sciuto S, Bernardeschi D. Upper lateral cartilage suspension over dorsal grafts: a treatment for internal nasal valve dynamic incompetence. Facial Plast Surg 1999; 15 (04) 309-316
  • 13 Lee M, Inman J, Ducic Y. Central segment harvest of costal cartilage in rhinoplasty. Laryngoscope 2011; 121 (10) 2155-2158
  • 14 Byrd HS, Meade RA, Gonyon Jr DL. Using the autospreader flap in primary rhinoplasty. Plast Reconstr Surg 2007; 119 (06) 1897-1902
  • 15 Hamilton III GS. The external nasal valve. Facial Plast Surg Clin North Am 2017; 25 (02) 179-194
  • 16 Metzenbaum M. Replacement of the lower end of the dislocated septal cartilage versus submucous resection of the dislocated end of the septal cartilage. Arch Otolaryngol 1929; 9 (03) 282-296
  • 17 Kridel RWH, Scott BA, Foda HMT. The tongue-in-groove technique in septorhinoplasty. A 10-year experience. Arch Facial Plast Surg 1999; 1 (04) 246-256 , discussion 257–258
  • 18 Kim JH, Kim DY, Jang YJ. Outcomes after endonasal septoplasty using caudal septal batten grafting. Am J Rhinol Allergy 2011; 25 (04) e166-e170
  • 19 Boenisch M, Nolst Trenité GJ. Reconstruction of the nasal septum using polydioxanone plate. Arch Facial Plast Surg 2010; 12 (01) 4-10
  • 20 Rimmer J, Saleh H. Use of polydioxanone plate in septal reconstruction. Facial Plast Surg 2013; 29 (06) 464-472
  • 21 Gunter JP, Friedman RM. Lateral crural strut graft: technique and clinical applications in rhinoplasty. Plast Reconstr Surg 1997; 99 (04) 943-952 , discussion 953–955
  • 22 Toriumi DM, Josen J, Weinberger M, Tardy Jr ME. Use of alar batten grafts for correction of nasal valve collapse. Arch Otolaryngol Head Neck Surg 1997; 123 (08) 802-808
  • 23 Cochran CS, Sieber DA. Extended alar contour grafts: an evolution of the lateral crural strut graft technique in rhinoplasty. Plast Reconstr Surg 2017; 140 (04) 559e-567e
  • 24 Rohrich RJ, Raniere Jr J, Ha RY. The alar contour graft: correction and prevention of alar rim deformities in rhinoplasty. Plast Reconstr Surg 2002; 109 (07) 2495-2505 , discussion 2506–2508
  • 25 Murakami CS, Barrera JE, Most SP. Preserving structural integrity of the alar cartilage in aesthetic rhinoplasty using a cephalic turn-in flap. Arch Facial Plast Surg 2009; 11 (02) 126-128
  • 26 Nagarkar P, Stark RY, Pezeshk RA, Amirlak B, Rohrich RJ. Role of the cephalic trim in modern rhinoplasty. Plast Reconstr Surg 2016; 137 (01) 89-96
  • 27 Cingi C, Ure B, Cakli H, Ozudogru E. Microdebrider-assisted versus radiofrequency-assisted inferior turbinoplasty: a prospective study with objective and subjective outcome measures. Acta Otorhinolaryngol Ital 2010; 30 (03) 138-143
  • 28 Lee JY, Lee JD. Comparative study on the long-term effectiveness between coblation- and microdebrider-assisted partial turbinoplasty. Laryngoscope 2006; 116 (05) 729-734
  • 29 Chen YL, Liu CM, Huang HM. Comparison of microdebrider-assisted inferior turbinoplasty and submucosal resection for children with hypertrophic inferior turbinates. Int J Pediatr Otorhinolaryngol 2007; 71 (06) 921-927
  • 30 Lukka VK, Kurien R, Varghese L, Rupa V. Endoscopic submucosal resection versus endoscopic submucosal diathermy for inferior turbinate hypertrophy. Indian J Otolaryngol Head Neck Surg 2019; 71 (Suppl. 03) 1885-1894
  • 31 Grossan M. Empty nose syndrome: when the nose is worse after surgery. Arch Otorhinolaryngol Head Neck Surg 2018; 2 (01) 2
  • 32 Li C, Farag AA, Leach J. et al. Computational fluid dynamics and trigeminal sensory examinations of empty nose syndrome patients. Laryngoscope 2017; 127 (06) E176-E184
  • 33 Cottle MH. Nasal atrophy, atrophic rhinitis, ozena: medical and surgical treatment: repair of septal perforations. J Int Coll Surg 1958; 29 (04) 472-484
  • 34 Scheithauer MO. Surgery of the turbinates and “empty nose” syndrome. GMS Curr Top Otorhinolaryngol Head Neck Surg 2010; 9: Doc03